BILL NUMBER: SB 269	CHAPTERED  09/28/00

	CHAPTER   794
	FILED WITH SECRETARY OF STATE   SEPTEMBER 28, 2000
	PASSED THE SENATE   AUGUST 31, 2000
	PASSED THE ASSEMBLY   AUGUST 30, 2000
	AMENDED IN ASSEMBLY   AUGUST 29, 2000
	AMENDED IN ASSEMBLY   AUGUST 25, 2000
	AMENDED IN ASSEMBLY   AUGUST 7, 2000
	AMENDED IN ASSEMBLY   APRIL 24, 2000
	AMENDED IN SENATE   JANUARY 6, 2000

INTRODUCED BY   Senators Ortiz and Leslie
   (Coauthor:  Assembly Member Shelley)

                        FEBRUARY 1, 1999

   An act to amend Section 101230 of the Health and Safety Code,
relating to public health administration, and making an appropriation
therefor.

      (Approved by Governor September 28, 2000.  Filed with
Secretary of State September 28, 2000.)

   I am signing Senate Bill No. 269 with a reduction.  This bill
would set a funding allocation methodology for local communicable
disease control and public health surveillance activities which are
important public health functions.  I included $1.6 million in the
Budget Act of 2000 for local public health activities.  Therefore, I
am reducing the appropriation from $4.9 million to $1 million to be
allocated on a proportional basis according to the formula in the
bill.
                                                 GRAY DAVIS, Governor


	LEGISLATIVE COUNSEL'S DIGEST


   SB 269, Ortiz.  Local public health administration:  state aid.
   Under existing law, state aid is provided to local health
departments for purposes of public health administration, including
for communicable disease control and community and public health
surveillance activities.  Under existing law, allocation of these
funds is made to the administrative bodies of qualifying local health
jurisdictions described as public health administrative
organizations, and includes a basic allotment of $100,000 per local
health jurisdiction or $0.212426630 per capita, whichever is greater.

   This bill would enact the "Public Health Improvement Act of 1999,"
which would make the allocation of these funds subject to the
availability of funds in the annual Budget Act or some other act,
appropriate $4,935,000 from the General Fund for this purpose,
provide for a specified allocation of the funds appropriated, and
would state related legislative intent.
   Appropriation:  yes.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:


  SECTION 1.  (a) This act shall be known and may be cited as the
"Public Health Improvement Act of 1999."
   (b) The Legislature finds and declares as follows:
   (1) Local control of communicable diseases is a well recognized
core public health function, comparable to the public safety mission
of law enforcement.
   (2) The tools to battle communicable diseases are well known and
time honored.  These tools involve basic prevention, identification,
and control efforts that result in a benefit to all in society.
These tools include disease surveillance systems, diagnostic
capabilities, disease intervention, health education, and a broad
disease prevention program.
   (3) Local communicable disease control surveillance and reporting
activities are the backbone of the state's communicable disease
control efforts.  Without an effective local reporting and
surveillance system, control of communicable disease is not possible
in California.
   (4) The local reporting and surveillance system is severely
strained and underfunded.  Scientific and professional capacity has
not grown with the state's increasing population and complexity of
problems.  There are many instances where key medical and public
health laboratory personnel have been reduced in local health
departments.
   (5) The number of infectious diseases newly emerging or reemerging
in California has increased sharply in just the past few years.
Diseases including bloody diarrhea due to E. Coli 0157:H7, hantavirus
pulmonary syndrome, Cyclospora, egg-associated salmonellosis, and
bacterial infections resistant to all antibiotics have appeared
within the last three years, in addition to the eight new sexually
transmitted diseases recognized since 1980.  Multiple drug resistant
TB, and valley fever have reemerged as major health threats.
   (6) The federal Centers of Disease Control and Prevention and the
United States Food and Drug Administration have both urged state
action as a critical part of their emerging pathogens prevention
strategy.  The FDA has pointed out that only two states, Minnesota
and Washington, are well prepared to identify and manage E. Coli
0157:H7 outbreaks.  In fact, despite sporadic cases in contiguous
California counties, it was Washington state that alerted California
about the recent multistate outbreak initially attributed to raw
apple juice.
   (7) A joint survey of local health departments conducted by the
California Conference of Local Health Officers and the State
Department of Health Services in 1998 determined that over 22 million
dollars ($22,000,000) would have to be spent on basic scientific
personnel to fill this gap in the capability to control and prevent
the spread of disease.
   (8) In 1947, the Legislature allotted 3 million dollars
($3,000,000) to local health jurisdictions for the basic core disease
prevention services.  The current amount is seven hundred eight
thousand dollars ($708,000).  As a result, basic public health
programs, such as communicable disease control and disease
surveillance, have eroded.
   (9) Rural county health jurisdictions in California have a unique
and chronic need for additional resources to provide basic disease
prevention services.  Rural health agencies currently operate under
tightly constrained budgets.  Nonetheless, rural health agencies are
responsible for controlling infectious outbreaks covering vast
geographic distances where accessible health facilities are few and
far apart.  Rural health agencies are under pressure from the special
needs of resident populations and from the increasingly large
demands placed upon rural health agencies by tourists and visitors to
California's great natural or scenic recreational areas.
   (c) (1) It is therefore the intent of the Legislature that local
geographically based prevention services be strengthened and enhanced
in California to provide for communicable disease control and
community health surveillance activities.
   (2) It is the further intent of the Legislature that, in
conjunction with a proposal to enhance funding for an emerging
infectious disease program at the state level, that the Legislature
seek to enhance and strengthen the capability of local health
jurisdictions to form a state-local system to control communicable
disease and to closely monitor the health status of the state's
population.
  SEC. 2.  Section 101230 of the Health and Safety Code is amended to
read:
   101230.  From the appropriation made for the purposes of this
article, allocation shall be made to the administrative bodies of
qualifying local health jurisdictions described as public health
administrative organizations in Section 101185 in the following
manner:
   (a) A basic allotment as follows:
   To the administrative bodies of local health jurisdictions a basic
allotment of one hundred thousand dollars ($100,000) per local
health jurisdiction or $0.212426630 per capita, whichever is greater,
subject to the availability of funds appropriated in the annual
Budget Act or some other act.  The population estimates used for the
calculation of the per capita allotment shall be based on the
Department of Finance's E-1 Report, "City/County Population Estimates
with Annual Percentage Changes" as of January 1 of the previous
fiscal year.  However, if within a county there are one or more city
health jurisdictions, the county shall subtract the population of the
city or cities from the county total population for purposes of
calculating the per capita total.  If the amounts appropriated are
insufficient to fully fund the allocations specified in this
subdivision, the State Department of Health Services shall prorate
and adjust each local health jurisdiction's allocation using the same
percentage that each local health jurisdiction's allocation
represents to the total appropriation under the allocation
methodology specified in this subdivision.
   (b) A per capita allotment, determined as follows:
   After deducting the amounts allowed for the basic allotment as
provided in subdivision (a), the balance of the appropriation, if
any, shall be allotted on a per capita basis to the administrative
body of each local health jurisdiction in the proportion that the
population of that local health jurisdiction bears to the population
of all qualified local health jurisdictions of the state.
   (c) Beginning in the fiscal year 1998-99, funds appropriated for
the purposes of this article shall be used to supplement existing
levels of the services described in paragraphs (1) and (2) of
subdivision (d) provided by qualifying participating local health
jurisdictions.  As part of a county's or city's annual realignment
trust fund report to the Controller, a participating county or city
shall annually certify to the Controller that it has deposited county
or city funds equal to or exceeding the amount described in
subdivisions (a) and (b) of Section 17608.10.  The county or city
shall not be required to submit any additional reports or
modifications to existing reports to document compliance with this
subdivision.  Funds shall be disbursed quarterly in advance to local
health jurisdictions beginning July 1, 1998.  If a county or city
does not accept its allocation, any unallocated funds provided under
this section shall be redistributed according to subdivision (b) to
the participating counties and cities that remain.
   (d) Funds shall be used for the following:
   (1) Communicable disease control activities.  Communicable disease
control activities shall include, but not be limited to,
communicable disease prevention, epidemiologic services, public
health laboratory identification, surveillance, immunizations,
followup care for sexually transmitted disease and tuberculosis
control, and support services.
   (2) Community and public health surveillance activities.  These
activities shall include, but not be limited to, epidemiological
analyses, and monitoring and investigating communicable diseases and
illnesses due to other untoward health events.
   (e) Funds shall not be used for medical services, including jail
medical treatment, except as provided in subdivision (d).
  SEC. 3.  (a) The sum of four million nine hundred thirty-five
thousand dollars ($4,935,000) is hereby appropriated from the General
Fund to the State Department of Health Services for allocation to
administrative bodies of qualifying local health jurisdictions for
purposes of implementing Section 101230 of the Health and Safety
Code.
   (b) (1) Notwithstanding subdivision (a) of Section 101230 of the
Health and Safety Code, the funds shall be allocated so that each
jurisdiction receives one hundred thousand dollars ($100,000) or its
allocation for the 1999-2000 fiscal year, whichever is greater.
   (2) Notwithstanding paragraph (1), if the funds appropriated are
insufficient to completely implement paragraph (1), allocations shall
be made pursuant to this paragraph.  In the first instance, no
jurisdiction shall receive less than its allocation for the 1999-2000
fiscal year.  Secondly, for those jurisdictions for which the
allocation pursuant to paragraph (1) would have been less than one
hundred thousand dollars ($100,000), the allocation shall be reduced
proportionately, by dividing the number of those jurisdictions by the
funds remaining after the minimum allocations to all jurisdictions
are made under this paragraph.
